posted
If they broke contract with you...SUE THE #$#$ OUT OF THEM
i wish it was that simple. i had a good case, but i also had agood lawyer and he told me that by the tme we sued and won? i would not get enough money to make it owrth my while.
he said i would have to be happy with winning in principle. the co's know this, they have the best lawyers on retainer and they pay them anyway....
paperwork and discovery can become very expensive.
in spite of all the big cases you hear about on the news? they are very rare as a percentage of overall cases...
-------------------- Don't envy the happiness of those who live in a fool's paradise.
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posted
If they broke contract with you...SUE THE #$#$ OUT OF THEM. I meant that when I wrote it. If they failed to live up to the contractual agreement that they entered into with you then litigate till they do.
The only one I can (afford to) sue is the lawyer who represented me against the mortgage company. And I'm going to...
If that's how it came across I apologize, Tex. That was nowhere near my intent. My intent was to show that for every (major) claim made, rarely has that same amount been paid by the applicant in premiums. Apology accepted, thanks.
The business model was dreamed up by the insurance companies, "betting" on the numbers, so it's a bit tautological to say "rarely has that same amount been paid by the applicant in premiums." My narrow point is they dreamed up the deal, so they should live by it instead of looking for loopholes. Yes, *I* came out OK--though shorted thousands of dollars and unable to replace my home with a similar quality home. My point about talking about me is simply that my personal experience is not pertinent to the discussion as a whole. I could provide many personal details that do apply, but the major points are: 1) insurance companies cheat people alla time [cf rescission ] 2) not enough people have health insurance, and ethically that's wrong 3) the obfuscation and even hate coming from the naysayers seem more directed at manifesting Obama's "waterloo" instead of joining in a sincere debate.
-------------------- Nashoba Holba Chepulechi Adventures in microcapitalism...
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1) insurance companies cheat people alla time [cf rescission ]
As you've shown, it does happen. My caveat would be that we need to make sure we're not generalizing. Do ALL insurance companies cheat their clients? Or only the sad few giving them all a bad name (like bad cops).
quote:2) not enough people have health insurance, and ethically that's wrong
I would love for everyone to have alot of things, Tex. That doesn't mean that society in general has rated it high enough of a priority to forgo other things to pay for it yet.
quote:3) the obfuscation and even hate coming from the naysayers seem more directed at manifesting Obama's "waterloo" instead of joining in a sincere debate.
Agreed. Political football at it's finest (worst). This is why I've tried to vocalize specific points where I disagree (ie. surtax on rich, killing privatization in sector).
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posted
As you've shown, it does happen. My caveat would be that we need to make sure we're not generalizing. Do ALL insurance companies cheat their clients? Or only the sad few giving them all a bad name (like bad cops).
obviously not all do.
however, there is an inherent flaw in the whole private insurance system.
that is that profits really are based on not paying claims. it is that simple.
as Tex said? he was not made whole in his ordeal, and as i didn't say but will now? i was not made whole either.
what your agent sells you is not what you get. your agents job is to sign you up, the adjusters job is to chisel you.
that's the truth in many things, not just insurance, but insurance is a contract, and none of us are competent to understand a contract written by those lawyers i mentioned earlier. you talk about not being able to understand a law? try actually reading your full homeowners contract.
this is why i laugh when people say they trust private industry more than the govt.
that's alot of foolishness. your only paranoid if they really are not out to get you(rmoney)
in fact? it is a state by state issue regualted and enforced differntly in each state,
and allowing insurance to be sold across state lines would make it much worse.
so making it more competitive by allowing sales across state lines will in fact make it easier for insurance companies to abuse teir customers.
-------------------- Don't envy the happiness of those who live in a fool's paradise.
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what your agent sells you is not what you get. your agents job is to sign you up, the adjusters job is to chisel you.
that's the truth in many things, not just insurance, but insurance is a contract, and none of us are competent to understand a contract written by those lawyers i mentioned earlier. you talk about not being able to understand a law? try actually reading your full homeowners contract.
this is why i laugh when people say they trust private industry more than the govt.
that's alot of foolishness. your only paranoid if they really are not out to get you(rmoney)
in fact? it is a state by state issue regualted and enforced differntly in each state,
_________________________________________________
The insurance companies are not suppose to cheat us.
They do make it hard on you many times, even though we pay for their service and are suppose to get "service" when we need it most.
You are protected by law from insurance companies cheating us by what's called a bad faith claim, which worries insurance companies the most.
The big problem as always is that we have to prove that there is bad faith and generally need a lawyer to do that.
Insurance companies are there to make money, where is the government is suppose to be there to serve, we the people.
So many times it seems like the government is there to serve a few and many outside of the goverment reap the benefits, that's where one of the problem lies.
That is one of my big gripes with the VA compensation program, as some of you know.
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posted
I would love for everyone to have alot of things, Tex.
I'm not concerned with "utopia." But coming up with a decent health-care system is crucial for this country, heading into the decades ahead.
Now that being said, I think Obama made a mistake: He should have focused on cleaning up the market. Not just band-aids, either, but fundamental shake-ups with strong, hands-on regulatory *and* enforcement power.
Back to medical...the system as is bad for everybody, really. There's insurance companies who won't pay, doctors who overcharge, and patients who scam. You may not consider chiropracty a medical field, but it *is* health care. I reworked a friend's back-office and started doing workman's comp and denied insurance claims.
Turns out, the insurance companies would routinely deny certain (broad categories) of cases...just cause. Then--if you took the trouble--upon resubmital, they would deny again and affix one of about 3-4 codes. Guess what those codes traced out to mean?
They were denied the second time because they had already been denied once.
The "trick"--which my buddy's office manager refused to do (I would've fired her)--was you had to stamp across the upper part of the top form (or write with Magic Marker) these specific words:
"Submitted for Reconsideration"
With that and a couple of other techniques I developed, I recovered about $50 grand in a few months that otherwise my buddy would have had to simply write off or spend *more* money on, for collection efforts to go after hurt people. These were people he was trying to help get better so they could work again.
Now, did he also have deadbeat clients? Sure. And it's always disappointing to cut peeps deals for cash discounts only to get stiffed. You're trying to help and you get stiffed. Nobody likes that...
But I guarantee you if ask him today which is the bigger problem, he'll tell you he could treat the deadbeats as medical "pro bono" if he didn't lose so much to bad insurance companies.
And we got lots of folks that are fenda to hit the health-care system in the next 30 years.
We better get it figgered out...
-------------------- Nashoba Holba Chepulechi Adventures in microcapitalism...
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posted
American people are sure funny. One of the issues OIbama was elected on was a public option medical insurance policy that any american could buy since it seems private insurance companies can't do the job. Well now he is close to doing the jo b and they are all choking and leaving the ship like rats I guess we have to have at least 150,000,000 people left uncovered for folks to demand health care that they can afford to purchase. I don't know why I care so much I have great medical coverage and so does my family. I just would like to see a much healthier nation with people that feel good.
Truman could see this and he could not get it done same for Richard Nixon,Hillary Clinton tried and Obama is losing ground to bad for thoes of you that need it you are letting the greedy criminal element win again
-------------------- Wise men learn more from fools than fools from the wise.
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quote:Originally posted by raybond: American people are sure funny. One of the issues OIbama was elected on was a public option medical insurance policy that any american could buy since it seems private insurance companies can't do the job. Well now he is close to doing the jo b and they are all choking and leaving the ship like rats I guess we have to have at least 150,000,000 people left uncovered for folks to demand health care that they can afford to purchase. I don't know why I care so much I have great medical coverage and so does my family. I just would like to see a much healthier nation with people that feel good.
Truman could see this and he could not get it done same for Richard Nixon,Hillary Clinton tried and Obama is losing ground to bad for thoes of you that need it you are letting the greedy criminal element win again
I knew the bill wouldnt get passed. 2010 is going to be a VERY interesting election season. Maybe they can focus on the problems on a different approach?
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quote:Originally posted by thinkmoney: What Obama should be focusing on is JOBS, JOBS , JOBS, and then deficit - also jailtime and fines, etc. for all the wall street criminals -
He also should apologize for a phony pork stimulus --
And, no more spending----
How exactly do you create JOBS JOBS JOBS, with no more spending?
Unless you are saying he should be courting Steve JOBS for a cabinet position.
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quote:Originally posted by thinkmoney: What Obama should be focusing on is JOBS, JOBS , JOBS, and then deficit - also jailtime and fines, etc. for all the wall street criminals -
He also should apologize for a phony pork stimulus --
And, no more spending----
kinda what I was saying. Would that I were in Obama's position, the market would be getting severe, severe, severe comeuppance. Answer to me, and get that chit straight.
Frankly, I can't understand how certain homeowners--even neighborhoods--have not *even* been approached for a class-action suit in the realm of the tobacco precedent.
Sad to say, some more spending may be necessary.
Still, the push for health-care revolution is ill-timed, I agree. It's necessary, but not *as* needed as market reform and jail time for the crooks.
Whacking Bernie ain't NEAR enough.
-------------------- Nashoba Holba Chepulechi Adventures in microcapitalism...
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posted
After the pork stimulus etc..- question I ask is how do we get more jobs? Well,
1. Less taxes for all esp. small business owners - 2. Hire americans first . I am in IT but in this mess I cant get work while many foreign workers are employed- give incentives to companies which hire american - 3. Stop outsourcing jobs or tax penalty and no tax benefits - Bring home our jobs and if companies put greed first then they should not get tax breaks - Also provide incentives to call centers, etc to get those jobs back in the USA and outsourced call centers give lousy service anyway - 4. Give tax incentives to growth industries - 5. There should be a buy american in stimulus - these are american tax dollars and should only support usa firms - and, that isnt protetionism - it is common sense dont get it that we dont have a buy american clause - 6. Stimulus should have been mostly infrastructure - 7. Give incentives to firms to avoid layoffs
Cut the deficit - Cut overall spending - Cut the fraud in government - But Obama did not put emphasis in job creation but pork stimulus then cap and trade and then health reform - sorry but I am an american and I want a country for my kids and work on jailing the croooks and get the money back, but jobs and deficit should be #1 priority --
Health reform is necessary but first you need a strong economy and definitely no pulic option -
But, Obama has tripled the deficit, raised taxes, and is using stimulus money for more welfare hand-outs for people who don’t deserve it. Which doesn’t create jobs; it creates a lazy, uneducated, and a worthless populous.
I say it this way to - the line for freebies gets longer and welfare state destroys incentive- the crux of job creation -
posted
1. Less taxes for all esp. small business owners -
they did that under Bush and we still lost jobs...and the economy still tanked.
when Reagan did it? the taxes were way higher... so it helped then, but as taxes get lower? cutting them more has less impact.
at some point? cutting taxes increases deficit spending which then causes inflation
small business owners pay about 10K to 14,000$ per year to insure their employees.
a govt plan would cut that about in half, and small business employers would realise considerable gains.
the insurance co's would lose tho, and that's the only valid complaint i've heard raised in all this health care argument. cutting costs would make insurance co's less profitable or even unprofitable.
people in general don't seem to understand that they cannot have everything they want...
7. Give incentives to firms to avoid layoffs
that is why they bailed out everybody they did...
to avoid up to 20 million people being layed off in one year.... of course many still got layed off, but it was not as many and it didn't happen all at once...
i agree with your buy American ideas, but the "conservative" people call it "protectionism"
-------------------- Don't envy the happiness of those who live in a fool's paradise.
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Do you disagree with my conclusion if the following is true:
IF an insurance company's risk is increased...
and
IF an insurance company is unable to raise money to offset said risk through raising premiums...
and
IF there is a competeing entity that has an unlimited amount of capital to use...
THEN
There would seem to be a problem with them being able to stay afloat long term?
I am going back through this thread as it has gotten away from me and though I know it wasn't directed at me I would like to answer.
My answer is that the pressure of competition forces the company to become more efficient and cost conscious without allowing the company to just cut problem customers out of the plan as an answer.
As Glass and others have posted medical insurance companies have some of the highest profit margins in the country. They also have some of the highest advertising budgets in the country. Are you really honestly concerned that they aren't gonna find a few corners to cut to make ends meet? I am not.
As to unlimited money....if these plans have unlimited resources then why is Medicare a decade away from going broke?
There is a funny human reaction that can happen when placed into a seeming no-win situation. It's called dependency or institutionalization depending on which type of situation is being discussed. It happens to battered women, kidnap victims, inmates in prison, the elderly. It's main characteristic is a unexplainable reliance and devotion to the very object or person which is restricting your freedoms.
I believe that in a large part this is some of the backlash that is being fought here. Most everyone in the country knows their wallets are being raped but many have been institutionalized into believing the system as it stands now is the only thing that is protecting their health.
Join me SF. Let's set our brothers and sisters free from their shackles!
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quote:Originally posted by SeekingFreedom: Ok, Tex, here's a part of my previous post I would love an answer to in regarding yours...
For all the problems you listed, did you receive more money (in total) than you've paid into the insurance companies (in total)?
I'm guessing just with the house fire claim you did.
So, in all, you've received more money than you spent...and still you're not happy?
Woah....SF....do we need to explain the definition of insurance and how it works? Cuz it sounds to me like you are mixing it up with your savings account.
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posted
yawn... that guys facts are very questionable:
Canada gets high ranking for cancer survival rates
Updated Wed. Jul. 16 2008 10:55 PM ET
CTV.ca News Staff
Canada has some of the best cancer survival rates in the world, and doctors are pointing to our much-maligned public health-care system as the reason.
In a report on worldwide cancer survival rates, Canada ranked near the top of the 31 countries studied with an estimate five-year survival rate of 82.5 per cent.
For breast cancer, Cuba had the highest survival rates -- another country with free health care.
The United States was second, and Canada was third, with 82 per cent of women surviving at least five years.
The U.S. has a five-year survival rate in all the cancers studied of 91.9 per cent, while Europe's is much lower at 57.1 per cent. However, survival rates within the U.S. can vary.
In Canada, the five Canadian provinces included in the study had almost identical results.
"For those five provinces, the survival rate does not differ very greatly from one to the other," said British cancer researcher Prof. Michel Coleman. "That probably indicates the overall effectiveness of universal health care for setting a high standard."
The range of survival rates across the five provinces was quite narrow, from a low of 79.3 per cent in Nova Scotia to a high of 85.4 per cent in British Columbia.
The other provinces studied were Manitoba, Ontario and Saskatchewan.
However, the survival rate for the seventeen regions in the United States that were included in the study ranged from 78 per cent to 90 per cent.
in other words? we are paying double what they are for 1/2 to 3 percentage rates higher. 1/2 to 3 percentage points can be accounted for by any number of things.
the average life expectancy for Canadians was 80.34 years compared with 78.6 years for residents of the U.S.
in Canada in 2000? they had a mortality rate of 180 per 100,000 for all types of cancer.
in the US in 2002 it was 194
but states vary considerably: from high Kentucky had 228 Louisaina had 222.8 MS has 217 WV had 215
to Utah and HI which were lowest at 144 and 145
that's the facts he's presenting as "better"
in fact? 42 states in the US have a higher mortality rate from cancer than Canada does:
what he like to ignore is that in the US we rank 33rd in infant mortality, which is interesting because that is about "well care" and saving babies is so high on the priority list of the very same people against govt health care.
maybe the most important point of all is that we already find ways to care for the people without healthcare. the fact is? the hospitals charge those of us with insurance already. so this increased cost cannot be calculated. it should actually go down because hospital care in the ER is five times more expensive than a dedicated clinic for poor people.
i am not for single payer. i just want people to understand that the facts are "elusive" at best and most of what i've been hearing is just plain lies.
[ August 21, 2009, 23:49: Message edited by: glassman ]
-------------------- Don't envy the happiness of those who live in a fool's paradise.
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quote:Woah....SF....do we need to explain the definition of insurance and how it works? Cuz it sounds to me like you are mixing it up with your savings account.
There is an old book I have somewhere around here called The Richest Man in Babylon. One of the chapters details the building of a massive wall around the city to protect them against possible future invaders. The expense involved was great, but less than what it would have cost had the invaders come in and sacked the city.
This is how I look at insurance. It's an investment against future catastrophe. However large the investment involved (read premiums), it will never be as much as a catastrophic expense would be without it.
We pay the insurance companies to offload our risk onto their shoulders. To accept that risk, they charge us what they calculate is needed at any one time to cover the needed expenses of their clients. If you never have to file a claim, then yes, you're probably better off stuffing the money in a savings account. But as shown in the preceding posts, disasters happen to everyone eventually. With insurance, you're not on your own to foot the bill. Without it, you better have been saving that money...cause you're going to need it.
That's why I look at it as I mentioned above as a amount invested vs. amount paid out by the insurance company view.
quote:As to unlimited money....if these plans have unlimited resources then why is Medicare a decade away from going broke?
Do you really, honestly think that whoever is in power in 2014 (projected date for medicare to run out of cash I believe) will allow everyone on medicare to go without care? Do you think that they won't simply pass legislation to re-fund the program? It will be the exact same way with this government run public option. Money WILL be found if it means saving votes.
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posted
Money WILL be found if it means saving votes.
and that is what they are trying to "insure against" by starting NOW!
people on medicare are truly afraid they will lose the benefits they have now, i am sure that i will not get the same benefits they are getting now when i am eligible
IMO? it all comes to the doctors shoulders. not that they have to take pay cut mind you, but they need to figure it out because the politicians just can't
-------------------- Don't envy the happiness of those who live in a fool's paradise.
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posted
I don't think the doctors are going to be given much of a choice in the matter, Glass.
On one hand, they accept the plan (however it turns out) and are forced to accept the new option with all of its price caps (and if anyone thinks that the gov isn't going to cap the prices the doctors can charge I have a bridge to sell you). On the other, they refuse to take patients with the public option (if the new plan even allows them to refuse them, which I doubt) and then they get demonized for being money grubbers.
No, no matter how the final plan unfolds, they are stuck with the consequences far worse than any of us will be.
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posted
I can tell you one reason the doctors don't like the new health care plan is they are not going to be able to double dip anymore. Obama said that is a no no anymore.
I could give you lots of examples but here is an easy one that just happenrd about 60 days ago to my neighbor on medicare. This nice lady had a pace maker installed and the first time the doc did it wrong so he did it over and got paid twice.
I know of very few service industries that get paid for screwing a job up and getting paid again to cover there screw up. One should have it so good
-------------------- Wise men learn more from fools than fools from the wise.
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posted
Let me get this straight... Are you actually arguing that government will for the first time in the history of humanity.. if not reality... INCREASE efficiency... reduce costs? Not sure where you left your drawing board but I'm thinking you need to go back to it.
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posted
The Government will manage health care much better than the private sectore will. And if you look at all the things the Government manages at all levels county,city,state and federal you will find most of them are done well.
-------------------- Wise men learn more from fools than fools from the wise.
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So you are... The same government that has just admitted they are going to take the ten year deficit to TEN TRILLION dollars is the government you are telling me is the pinnacle of efficiency? Where did that pesky drawing board go?
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This can be debated as to why we are in our terrible fix of debt but I do not want to get into that.
sanition,education,law,law enforcement, corrections,water,sewer,land management,defence,dmv. are just a few things the U.S. Government,state and city goverments do that is the envy of the world. I have seen a lot of the others and our Government does a damn good job.
-------------------- Wise men learn more from fools than fools from the wise.
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quote:Originally posted by Relentless.: So you are... The same government that has just admitted they are going to take the ten year deficit to TEN TRILLION dollars is the government you are telling me is the pinnacle of efficiency? Where did that pesky drawing board go?
when are people going to realise that the govt runs a deficit as a matter of POLICY? or that the so-called conservatives are the ones that have run the highest deficits and that they do it on purpose because it is the cheapest way to borrow money from people who don't even have it?
when are people going to realise that by running a deficit, and subsidising lending and borrowing they are able to increase the GDP by as much as 20 percent?
of course the govt is inefficient, it's run by humans.
but to try to glorify private enterprise as some sort of model of efficiency even in comparison is ludicrous.
if the govt had not stepped in four seperate and distinct time in the last 100 years? we'd still be riding horses.
before that? how did our railroads get built? it wasn't simply because of a few aggressive induastrialists, the industrialists used the govt to their own particualr ends to acquire the land they needed to build them on..
same goes with the damn power grid. the GOVT had to be there to take the land from the rightful owners. look up the history of the Tennesse Valley Authority sometime...
the economy we have today could not exist without a relatively powerful centralised govt. the alternative to that would be an industrial fuedalistic society.
-------------------- Don't envy the happiness of those who live in a fool's paradise.
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